Sepsis in horses is a systemic inflammatory response to infection, characterized by the presence of pathogenic microorganisms or their toxins in the blood or tissues. It can result from various bacterial, viral, or fungal infections and may lead to severe complications if not managed promptly. Clinical signs of sepsis in horses can include fever, increased heart and respiratory rates, altered mucous membrane color, and signs of organ dysfunction. Diagnosis often involves identifying the underlying infection source, alongside laboratory tests to detect inflammatory markers and organ function indicators. This page compiles peer-reviewed research studies and scholarly articles that explore the pathophysiology, diagnosis, treatment, and prognosis of sepsis in equine patients.
Ralston SL.Horses suffering from trauma, sepsis, and severe burns need 12% to 16% of protein (dry matter basis) in their diet. Since reduced appetite may be a problem, relatively energy dense (greater than 2 Mcal DE/kg) feeds should be offered. In hepatic failure, maintenance protein requirements (8% on a dry matter basis for adult horses) should be met with feeds that are high in short branched-chain amino acids and arginine but low in aromatic amino acids and tryptophan (for example, milo, corn, soybean, or linseed meal) in addition to grass hay. Vitamins A, C, and E should also be supplemented. In cas...
Brumbaugh GW, Benson PA.Samples of pleural fluid from 20 horses with effusive pleural diseases of various causes were evaluated; samples from 19 horses were used for the study. There were differences for pH (P = 0.001) and partial pressure of oxygen (PO2) between arterial blood and nonseptic pleural fluid (P = 0.0491), but there were no differences for pH, PO2, partial pressure of carbon dioxide (PCO2), and concentrations of bicarbonate (HCO3-), lactate, and glucose between venous blood and nonseptic pleural fluid. Paired comparisons of venous blood and nonseptic pleural fluid from the same horse indicated no differe...
Schulz KS, Simmons TR, Johnson R.An 8-year-old mare was presented to the New York State College of Veterinary Medicine Large Animal Clinic for evaluation of anorexia, fever and icterus. The mare had a 5-day history of anorexia, depression and tongue protrusion. Diagnostic procedures included serum hepatic enzyme activities, serum bile acid concentrations, blood ammonia evaluations and hepatic ultrasound and ultrasound guided biopsy. The history, clinical pathology and histopathology in this case supported a probable diagnosis of primary septic cholangiohepatitis.
Baird AN, Taylor JR, Watkins JP.Radiographically, osteolysis of the physis consistent with a septic physitis was observed in 3 foals. The foals were treated with surgical debridement and antimicrobials. Two of the horses were sound for use as adults; the third was euthanatized due to concurrent infectious arthritis and septicemia.
Lavoie JP, Madigan JE, Cullor JS, Powell WE.The purpose of this study was to evaluate the effects of experimentally induced sublethal endotoxaemia in equine neonates. Four foals, between two and five days of age, were infused intravenously with 0.5 microgram/kg bodyweight of Salmonella typhimurium endotoxin (LPS) over a 5 h period. A four-day-old and a five-day-old foal, similarly infused with sterile isotonic saline, served as controls. Clinical signs were monitored, blood samples obtained for evaluation of selected haematological and biochemical parameters; and haemodynamic parameters were recorded hourly during the infusion, as well ...
Adland-Davenport P, Brown MP, Robinson JD, Derendorf HC.Fourteen foals less than four days of age were treated with the aminoglycoside, amikacin sulphate, and either penicillin or ampicillin for septicaemia, pneumonia, and/or failure of passive immunoglobulin transfer. Serum amikacin concentrations were determined at three times during an 8 or 12 h dosing interval. A 7.0 mg/kg bodyweight dose of amikacin every 8 h was appropriate. Prematurity did not influence mortality. All seven premature foals survived, whereas four of the seven full term foals died. Uraemia in three foals was caused by urinary bladder rupture; amikacin-induced nephrotoxicity wa...
Gustafson SB, McIlwraith CW, Jones RL.Four groups of 8 horses each had 1 midcarpal joint injected with 33 colony-forming units (CFU) of viable Staphylococcus aureus plus: 1 ml of saline solution (group 1, control), 250 mg of polysulfated glycosaminoglycan (PSGAG, group 2), 100 mg of methylprednisolone acetate (group 3), or 20 mg of sodium hyaulronate (group 4). Horses were euthanatized, and samples were obtained on the basis of clinical signs of septic arthritis that were nonresponsive to phenylbutazone administration. One group-1 horse, all 8 group-2 horses, 3 group-3 horses, and 4 group-4 horses were culture-positive for S aureu...
Gustafson SB, McIlwraith CW, Jones RL, Dixon-White HE.Polysulfated glycosaminoglycan (PSGAG) recently have been reported to potentiate the infectivity of Staphylococcus aureus in horses with experimentally induced septic arthritis. Four groups of 8 horses each had 1 midcarpal joint injected with approximately 33 viable colony-forming units (CFU) of S aureus plus either 1 ml of saline solution (group 1), 250 mg of PSGAG (group 2), 250 mg of PSGAG passed through a 0.6-microns filter (group 3), or 250 mg of PSGAG plus 125 mg of amikacin (group 4). Horses that developed clinical signs consistent with sepsis were euthanatized, and samples were collect...
Spurlock GH.The prognosis for returning horses with open joint injuries to athletic function is most closely related to the duration of the injury prior to treatment. Prompt diagnosis and appropriate therapy should yield a favorable result. Delayed diagnosis or inappropriate therapy that allow the wound to progress to an infected state makes the likelihood of return to athletic function poor. Refractory joint infection can occur despite early diagnosis and prompt appropriate therapy. The development of these infections is undoubtedly increased by tissue loss and gross contamination. Appropriate antibiotic...
Gaughan EM, Rendano VT, Ducharme NG.Over an 8-year period, 9 horses with septic pedal osteitis were admitted to the New York State College of Veterinary Medicine. Septic pedal osteitis was defined by the presence of purulent exudate combined with radiographic evidence of lysis of the distal phalanx. The condition described involved only the distal phalanx, the laminae and hoofwall, and the soft tissues of the sole. Treatment included curettage and removal of the affected portion of the distal phalanx through a ventral approach to the foot, combined with systemic administration of antibodies. Of the 9 horses, 7 returned to soundn...
Young DR, Divers TJ, Benson CE.Clinical septicemia developed in 2 clinically normal horses after both were administered a portion of an amino acid solution IV. Serratia marcescens was subsequently isolated from blood of both horses. The isolates were shown to be identical on the basis of antibiograms and plasmid biochemistry, incriminating the infusate as the source of bacterial infection. The horses recovered after supportive and antimicrobial treatment.
Spier SJ, Lavoie JP, Cullor JS, Smith BP, Snyder JR, Sischo WM.Thirty-two horses with clinicopathologic evidence of endotoxic shock were randomly selected for a double-blind trial of hyperimmune lipopolysaccharide (LPS) core antigen plasma. Horses were suffering from acute toxic enteritis (n = 15), 360 degrees volvulus of the large colon (n = 9), proximal jejunitis/duodenitis (n = 6), or strangulating obstruction of the small intestine (n = 2). Plasma was harvested from suitable equine plasma donors (preimmune plasma) and horses were immunized with a whole-cell bacterin of an Rc mutant E. coli (J5). Plasma was again harvested from these horses when IgG EL...
Fessler JF, Bottoms GD, Coppoc GL, Gimarc S, Latshaw HS, Noble JK.Endotoxin (LPS) was quantitated in experimental subjects and in horses with naturally occurring gastrointestinal strangulation obstruction and/or septicaemic diseases to establish the fate of LPS and the clinical usefulness of the Limulus amoebocyte lysate (LAL) assay. The assay was validated for sensitivity (10 pg/ml), recovery (90 to 106 per cent), intra-assay precision (CV = 5.5 per cent) inter-assay precision (CV = 11 per cent), and stability of diluted, heat treated, frozen samples (at least 90 days). Plasma concentrations of LPS after sublethal (3 micrograms/kg) jugular or portal vein bo...
Vaala WE, Clark ES, Orsini JA.Gram-negative neonatal septicemia was diagnosed in a premature Standardbred colt. Clinical signs included lethargy, weakness, loss of suckle reflex, tachypnea, and injected mucous membranes. Sequelae included pneumonia, omphalophlebitis, septic arthritis, and osteomyelitis. Prepartum maternal uterine infection, premature delivery, abnormal parturition with premature fetal membrane separation, and failure of passive transfer of colostral immunoglobulins increased the foal's risk for developing sepsis. Treatment included administration of moxalactam disodium and cefadroxil. The clinical efficacy...
Morris DD.This article reviews normal hemostasis in order to provide the reader with the basis for understanding the pathogenesis and manifestations (both clinical and laboratory) of disseminated intravascular coagulation (DIC) in horses. DIC is subsequently discussed. The diagnosis and treatment of DIC in horses are also described.
Hondalus MK, Lofstedt J.A 16-year-old pony with signs of intermittent abdominal pain was treated with phenylbutazone in excess of the recommended dosage. Endoscopy revealed ulceration of the esophagus, stomach, and proximal portion of small intestine. The pony developed diarrhea. Salmonella typhimurium was isolated from the blood and feces. Treatment included fluids, trimethoprim-sulfadiazine, sucralfate, and ranitidine hydrochloride. The diarrhea resolved, as did the gastrointestinal ulceration. This case was unusual because septicemia with salmonellosis is an uncommon finding in adult equids. Also, complications co...
Belknap J, Arden W, Yamini B.A 2-month-old Standard-bred colt with signs of abdominal pain and large scrotum was found to have septic periorchitis involving the right testis. Surgical exploration of the abdomen and scrotum was performed; the colt was then castrated. Actinobacillus equuli was isolated from specimens obtained at surgery. The colt was treated with broad-spectrum antibiotics and flunixin meglumine after surgery, and fully recovered. The clinical signs of periorchitis in the colt were similar to an inguinal/scrotal hernia.
Adams R, Koterba AM, Brown MP, Cudd TC, Baker WA.The medical records of 20 neonatal foals in which exploratory celiotomies were performed for gastrointestinal disease were reviewed. In all 20 foals, persistent pain and/or progressive abdominal distension were the primary clinical findings influencing the decision to operate. However, ancilliary laboratory data were important to the proper medical management of these foals during anaesthesia and following surgery. Surgical diagnoses of the 20 foals included ileus (nine foals; 45 per cent), small colon obstruction (five foals; 25 per cent), large colon displacement (three foals; 15 per cent), ...
Brewer BD, Koterba AM.A sepsis scoring system was developed and tested prospectively in a blind study of 190 neonatal foals admitted to the University of Florida Veterinary Medical Teaching Hospital's neonatal intensive care unit. The system used 14 readily available historical, clinical or laboratory variables and weighted each item to arrive at a sepsis score. The score was found to have a sensitivity of 93 per cent, a specificity of 86 per cent, positive accuracy rate of 89 per cent and negative accuracy rate of 92 per cent. The sepsis score was far more sensitive and specific for infection, even in very early c...
Divers TJ, Whitlock RH, Byars TD, Leitch M, Crowell WA.Six horses had been admitted to the hospital because of illness other than renal failure; diarrhoea, myositis, abdominal pain and/or suspected bacterial sepsis. Hypotension and disseminated intravascular coagulopathy were frequent findings in the horses. Abnormally high serum creatinine concentration and urine specific gravity of less than 1.022 were found in the horses with acute renal failure. Hyponatraemia and hypochloraemia were the most common abnormal electrolyte findings. Pronounced hyperkalaemia was not found. Variable degrees of tubular necrosis were seen in three of the four horses t...
Sojka JE, Brown SA.Serum gentamicin concentrations were measured and pharmacokinetic values were calculated for 12 equine patients receiving parenteral gentamicin therapy. Horses were selected for monitoring of gentamicin pharmacokinetics if they met several criteria of high risk for gentamicin-induced toxicosis. Two blood samples were obtained, one immediately before gentamicin dosing and one at 1 hour after dosing. Gentamicin serum concentrations were analyzed and dosage adjustments were made on the basis of calculated one-compartment pharmacokinetic values. Nine of the 12 horses required dosage adjustment to ...
Baxter GM.Clinical data from 12 cases of equine laminitis characterized by distal displacement of the distal phalanx (P3) were reviewed. Clinical features of horses that survived the syndrome were compared with the nonsurvivors to obtain prognostic indicators. Animals affected included 8 Quarter Horses, 2 Welsh ponies, 1 Thoroughbred, and 1 Arabian. Eight of the animals were females (67%), 2 were stallions, and 2 were geldings. The mean age of affected animals was 8.6 years (2 to 14 years), and the mean body weight was 442 kg. The survivors weighed less than the nonsurvivors (384 kg vs 473 kg, respectiv...
Todhunter RJ, Erb HN, Roth L.The historical, clinical, laboratory, surgical and necropsy findings in 54 cases of gastric rupture in horses are described. Eleven per cent of the deaths of horses undergoing exploratory coeliotomy for colic during the period of the study were a result of gastric rupture. Comparison with all horses which had exploratory coeliotomies for colic over an eight year period did not show that horses with gastric rupture were different from these reference horses regarding age, breed or season. There were fewer stallions than expected in the gastric rupture group. Horses with histories of both acute ...
Dean PW, Robertson JT.Seven horses were used to compare the Gambee, the crushing, and a 2-layer inverting suture pattern composed of a simple continuous layer in the mucosa oversewn with a continuous Lembert pattern in the seromuscular layer. Horses were evaluated at 30 days for adhesion formation, lumen diameter, and quality of healing at the anastomotic sites. One horse was euthanatized 9 days after surgery after 24 hours of ileus and colic; necropsy revealed septic peritonitis and widespread adhesions. One horse had no adhesions. The remaining horses had adhesions associated with 50% of the Gambee and 50% of the...
Koterba AM, Brewer B, Drummond WH.Foal septicemia is a major cause of neonatal morbidity and mortality. In order to improve success rates, earlier diagnosis and treatment are essential. This article stresses methods to prevent and treat infections in the compromised equine neonate.
Mackey VS, Pool RR.Fracture of the lateral wing of the third phalanx with secondary infection of the distal interphalangeal joint occurred in a neurectomized mare. Puncture of the sole may have been the inciting cause, emphasizing the need for careful daily foot care in neurectomized horses.
Kosch PC, Koterba AM, Coons TJ, Webb AI.Developments in evaluation of newborn foals with respiratory distress are discussed. Major causes of respiratory distress are outlined and discussed in terms of the similar respiratory signs exhibited by foals with this clinical syndrome. History, physical examination, clinical pathology, chest radiography and blood gas analyses are discussed as important elements of the evaluation of the condition of these foals. Foals with respiratory disease are grouped into three major categories on the basis of clinical signs and arterial blood gas profiles. The evaluation of foals with respiratory distre...
Giancola S, Hart KA.Blood culture is considered the gold standard test for documenting bacteraemia in patients with suspected bacterial sepsis in veterinary and human medicine. However, blood culture often fails to yield bacterial growth even though the clinical picture is strongly suggestive of bacterial sepsis, or contaminating organisms can overgrow the true pathogen, making accurate diagnosis and appropriate management of this life-threatening condition very challenging. Methodology for collecting blood cultures in equine medicine, and even in human hospitals, is not standardised, and many variables can affec...
Divers TJ.Regulation of renal blood flow is by both extrinsic and intrinsic systems. Intrinsic regulation occurs via the afferent and efferent arterioles and tubuloglomerular feedback mechanisms with activation of the juxtaglomerular apparatus. Mechanisms of acute kidney injury are frequently associated with changes in renal blood flow. Acute tubular necrosis and apoptosis are common in horses following ischemic or toxic insults and in sepsis-associated acute kidney injury. Sepsis-associated renal injury often has a complex mechanism of disease involving both functional and obstructive changes in intrar...
Gilday RA, Wojnarowicz C, Tryon KA, Lohmann KL.A Canadian warmblood foal treated for septic polyarthritis was diagnosed with bilateral congenital renal dysplasia, hydronephrosis, and hydroureter at 2 weeks of age based on abdominal ultrasound and postmortem examination. Intermittent abdominal pain throughout the course of treatment was attributed to hydronephrosis and hydroureter. Un poulain Warmblood canadien traité pour une polyarthrite septique a été diagnostiqué avec de la dysplasie rénale congénitale bilatérale, de l’hydronéphrose et de l’urétérohydrose à l’âge de 2 semaines en se fondant sur une échographie abdomi...
Steel CM, Hunt AR, Adams PL, Robertson ID, Chicken C, Yovich JV, Stick JA.To identify factors affecting the prognosis for survival and athletic use in foals with septic arthritis. Methods: Retrospective study. Methods: 93 foals with septic arthritis. Methods: Medical records were reviewed to obtain clinical findings, laboratory test results, radiographic findings, treatment method, and outcome. Race records for Thoroughbreds and Standardbreds were evaluated to determine whether foals subsequently raced and whether they raced successfully. Results: 43 foals had 1 affected joint, 44 foals had multiple affected joints, and number of affected joints was not recorded for...
Belknap J, Arden W, Yamini B.A 2-month-old Standard-bred colt with signs of abdominal pain and large scrotum was found to have septic periorchitis involving the right testis. Surgical exploration of the abdomen and scrotum was performed; the colt was then castrated. Actinobacillus equuli was isolated from specimens obtained at surgery. The colt was treated with broad-spectrum antibiotics and flunixin meglumine after surgery, and fully recovered. The clinical signs of periorchitis in the colt were similar to an inguinal/scrotal hernia.
Catunda APN, Alves GES, Paes Leme FO, Carvalho AM, Leise BS, Johnson PJ, Faleiros RR.Inflammation and apoptosis in the hoof lamellar interface both contribute to the early stages of sepsis-associated laminitis, but it is not clear whether apoptosis is occurring before the onset of inflammation or is being provoked by inflammation. Apoptosis and inflammation were therefore measured in lamellar tissues obtained at different time points throughout the early stages of experimentally induced laminitis. Apoptotic cells and leukocyte were enumerated in archived paraffin embedded lamellar tissue samples from previous experiments in which acute laminitis was induced using Black Walnut ...
Neil KM, Axon JE, Begg AP, Todhunter PG, Adams PL, Fine AE, Caron JP, Adkins AR.To determine the clinical characteristics, short-term outcome and future athletic performance of foals with septic osteomyelitis. Methods: Retrospective clinical study of 108 Thoroughbred foals with radiographic evidence of bone infection that were presented at the Scone Veterinary Hospital between August 1995 and December 2001. Medical records were reviewed and information concerning signalment, the clinical, laboratory and radiographic findings, treatment and outcome was obtained. Racing records were obtained and evaluated for surviving foals that had reached racing age. Results: Mean age of...
Douglas H, Midon M, Shroff K, Floriano D, Driessen B, Hopster K.The placement of caudal epidural catheters in horses has become more frequent as a multi-modal analgesic strategy. Despite its integration into clinical practice, there are limited reports describing the use of caudal epidural catheterization for prolonged use in horses. The purpose of this study was to characterize the hospitalized caseload undergoing epidural catheterization for long-term epidural analgesic administration, to report the response to epidural therapy and observed complications, and to describe patient outcomes. Medical records of hospitalized equine patients that underwent pla...
Robinson JA, Allen GK, Green EM, Fales WH, Loch WE, Wilkerson CG.Fourteen mares and their foals were attended at parturition. After mare-foal bonding, 8 colostrum-deprived (CD) foals were removed from their dams, deprived of colostrum, and provided with an alternative milk source for the first 24 h of life. The mares were milked out every 2-4 h during this period to remove colostrum, after which the CD foals were returned to their mares and allowed to nurse. Six colostrum-fed (CF) foals were allowed to suck colostrum in the normal manner. Foal serum IgG concentration was determined by single radial immunodiffusion (means, CD = 0 mg/dl; CF = 1,508 mg/dl). Ac...
Labelle AL, Hamor RE, Townsend WM, Mitchell MA, Zarfoss MK, Breaux CB, Thomasy SM, Hall T.To determine types and frequency of ophthalmic lesions detected in neonatal foals evaluated for nonophthalmic disease at 3 veterinary referral hospitals and to investigate associations between systemic and ophthalmic diseases in these foals. Methods: Prospective cross-sectional study. Methods: 70 foals < 30 days old. Methods: Complete ophthalmic examinations were performed. Signalment, clinical signs, mentation during ophthalmic examination, results of clinicopathologic tests, and diagnosis of systemic disease were recorded. Descriptive data analysis including a χ(2) test for associations was...
Hawthorn A, Reardon R, O'Meara B, James F, Bladon B.The overall rate of sepsis following endoscopic surgery of synovial structures has not previously been documented. Clinical observation has led to the conjecture that tendon sheaths, in particular the carpal flexor tendon sheath, are more prone to post operative synovial sepsis than other synovial structures. Objective: To document and investigate the rate of post operative synovial sepsis following elective endoscopic surgery. Methods: Retrospective case series. Methods: The medical records of horses that underwent arthroscopy, tenoscopy or bursoscopy at Donnington Grove Veterinary Surgery be...
Honnas CM, Schumacher J, Kuesis BS.A 6-month-old 300-kg Quarter Horse filly was treated for septic arthritis of the distal interphalangeal joint and septic navicular bursitis that developed as a result of a deep puncture to the foot. Initial treatment consisted of establishing ventral drainage for the navicular bursa, lavage of the distal interphalangeal joint, and administration of broad-spectrum antimicrobial drugs and non-steroidal anti-inflammatory drugs. Because of continuing sepsis in the distal interphalangeal joint, subsequent treatment included packing the defect in the bottom of the foot with cancellous bone in an att...
Ralston SL.Horses suffering from trauma, sepsis, and severe burns need 12% to 16% of protein (dry matter basis) in their diet. Since reduced appetite may be a problem, relatively energy dense (greater than 2 Mcal DE/kg) feeds should be offered. In hepatic failure, maintenance protein requirements (8% on a dry matter basis for adult horses) should be met with feeds that are high in short branched-chain amino acids and arginine but low in aromatic amino acids and tryptophan (for example, milo, corn, soybean, or linseed meal) in addition to grass hay. Vitamins A, C, and E should also be supplemented. In cas...
Hackett ES, Lunn DP, Ferris RA, Horohov DW, Lappin MR, McCue PM.Neonatal sepsis is a common problem in foals and is a primary cause of death in the post natal period. Transient bacteraemia and subsequent host responses have not been described in the equine neonate. Objective: The primary objective of this study was to determine if transient bacteraemia occurs in foals within the first 72 h of life. Additional objectives included description of bacterial organisms associated with transient bacteraemia and concurrent cytokine gene expression in healthy foals. Methods: Prospective observational study in healthy foals. Methods: Blood was aseptically collecte...
Fraser BS, Bladon BM.Lacerations to the digital flexor tendon sheath (DFTS) are a common injury in the horse, but little information is available in the literature regarding prognostic indicators. Objective: To ascertain whether laceration of the DFTS carried a better prognosis if treated by tenoscopic lavage, debridement and repair within 36 h of the original injury. Methods: A retrospective analysis of 39 horses treated surgically for lacerations to the DFTS was performed over a 3 year period. The injury-to-surgery interval was recorded as <36 or >36 h. The structures damaged by the injury were also recorded, as...
Mair TS.Eight horses with Grade 3b rectal tears of the peritoneal part of the rectum or small colon were treated by a combination of medical therapy and dietary manipulation. All of the horses developed septic peritonitis during the course of treatment. Medical therapy consisted of a combination of penicillin, gentamicin and flunixin meglumine administered parenterally, metronidazole administered orally and liquid paraffin administered by nasogastric tube. Some horses also received fluid and electrolyte therapy i.v., plasma and heparin i.v. All horses were maintained on a laxative diet. Six of the 8 h...
Jacobsen S, Mortensen CD, Høj EA, Vinther AM, Berg LC, Adler DMT, Verwilghen D, van Galen G.Neutrophil gelatinase-associated lipocalin (NGAL) has been suggested to be a highly sensitive and specific marker of joint infection in humans. The aim of the study was to investigate NGAL concentrations in synovial fluid (SF) from horses with septic synovitis, horses without septic synovitis, and horses with uncertain status. NGAL was measured in 177 admission samples obtained from 152 horses. From a subset of horses ( = 35), additional samples obtained sequentially over the course of treatment were available. Concentrations of NGAL were significantly higher in septic synovitis ( = 47 samples...
Krause DM, Pezzanite LM, Griffenhagen GM, Hendrickson DA.Frequency of synovial sepsis in horses following intrasynovial injection has been reported, but not compared with respect to the environment in which the injection was performed. Objective: To describe occurrence of synovial sepsis following intrasynovial injections performed in ambulatory vs hospital settings. Methods: Retrospective cohort study. Methods: Records from the Colorado State University were evaluated (2014-2018) and horses receiving intrasynovial injections were identified. Patients presenting for septic synovial structures were excluded. Patient signalment, primary supervising se...
Clabough DL, Duckett W.An 8-year-old Arabian gelding with septic cholangitis and peritonitis was successfully treated with trimethoprim/sulfadiazine. The gelding was referred for evaluation of signs of abdominal pain, icterus, fever, and weight loss. Peritoneal fluid analysis revealed septic and suppurative peritonitis. Culture of the peritoneal fluid yielded Escherichia coli and Klebsiella pneumoniae, which were sensitive to trimethoprim/sulfadiazine. On the basis of results of hepatic ultrasonography, a diagnosis of septic cholangitis also was made. The horse was treated with 30 mg of trimethoprim/sulfadiazine/kg,...
Roy MF.Sepsis develops in horses when the host response to the invading pathogens is not properly balanced according to the severity of the insult. Several clinical conditions frequently encountered in equine practice may be associated with the development of sepsis and have the potential to progress to more severe forms, such as severe sepsis, MODS, and septic shock. Consequently, it is important for equine practitioners to be aware of the manifestations,pathophysiology, and treatment of sepsis. Although enormous progress has been made in recent years in our understanding of the pathophysiology of s...
East LM, Savage CJ, Traub-Dargatz JL, Dickinson CE, Ellis RP.To identify clinical signs, physical examination findings, results of diagnostic tests, treatments administered, and clinical outcome of neonatal foals with enterocolitis associated with Clostridium perfringens infection. Methods: Retrospective study. Methods: 54 neonatal foals. Results: Most foals had acute onset of obtunded mentation, colic, or diarrhea and developed leukopenia, neutropenia, an abnormally high number of band neutrophils, toxic WBC, and hypoproteinemia within 24 hours after admission, despite high serum IgG concentrations (> 800 mg/dl). Abdominocentesis and abdominal radiogra...
Fessler JF, Bottoms GD, Roesel OF, Moore AB, Frauenfelder HC, Boon GD.A study was made of flunixin meglumine (FM), an analgesic agent with antiprostaglandin activity, in the management of endotoxin-induced changes in ponies. Three groups of 5 ponies each were used: A--controls, B--nontreated ponies with endotoxin-induced shock, and C--ponies with endotoxin-induced shock treated with FM. Shock was induced in anesthetized ponies with IV injections of Escherichia coli endotoxin. Disruption of glucose homeostasis, insulin levels, hemograms, aerobic metabolism, and cell damage as indicated by plasma enzymes were observed. Treatment with FM (5 minutes) after shock was...
McClure SR, Hooper RN, Watkins JP.A 13-month-old Quarter Horse colt sustained a puncture wound to the frog region of the foot, which penetrated the navicular bursa and distal interphalangeal joint, 7 days prior to examination. A street-nail procedure was performed to debride the tract and provide drainage of the navicular bursa and distal interphalangeal joint. An indwelling lavage system was placed through the dorsal aspect of the joint and antimicrobials were infused intermittently to supply a high local concentration of drug and to frequently lavage the distal interphalangeal joint and navicular bursa.
Lescun TB, Morisset SM, Fugaro MN, Blevins WE.A 3-month-old Quarter Horse colt sustained a penetrating injury over the coronary band on the right forelimb resulting in an articular bone sequestrum and septic arthritis of the distal interphalangeal joint. Despite aggressive treatment for septic arthritis, severe osteoarthritis and ongoing sepsis resulted in persistent lameness. Facilitated ankylosis of the distal interphalangeal joint was performed using a combination of open surgical debridement, placement of an autogenous cancellous bone graft and stabilisation within a transfixation cast. Bony ankylosis of the joint was observed radiogr...
Palmer JE.Many sick neonatal foals have respiratory failure secondary to perinatal hypoxia, sepsis, or pneumonia. These foals require ventilatory support to prevent respiratory embarrassment and other complications associated with chronic hypoxia and hypercapnia. This article discusses practical aspects of ventilatory therapy, such as choosing a candidate for mechanical ventilation, choosing the proper ventilatory mode, placing a foal on a ventilator, maintaining a foal on mechanical ventilation, and weaning from mechanical ventilation. This article details some of the techniques that have been develope...
Tennent-Brown BS.Blood lactate concentration can be easily measured by practitioners using inexpensive point-of-care meters. Anaerobic tissue metabolism resulting from inadequate oxygen delivery (DO2) is the most important cause of an increase in blood lactate concentration in equine patients. However,hyperlactatemia also occurs under conditions of apparently adequate DO2, usually in association with sepsis and an intense inflammatory reaction. Numerous mechanisms have been proposed for aerobic hyperlactatemia, including increased Na+/K+-ATPase activity in response to inflammatory mediators; inhibition of pyru...
Lehavi O, Aizenstien O, Katz LH, Hourvitz A.Infection with Burkholderia mallei (formerly Pseudomonas mallei) can cause a subcutaneous infection known as "farcy" or can disseminate to condition known as Glanders. It is primarily a disease affecting horses, donkeys and mules. In humans, Glanders can produce four types of disease: localized form, pulmonary form, septicemia, and chronic form. Necrosis of the tracheobronchial tree and pustular skin lesions characterize acute infection with B. mallei. Other symptoms include febrile pneumonia, if the organism was inhaled, or signs of sepsis and multiple abscesses, if the skin was the port of e...
Scilimati N, Pepe M, Pressanto MC, Angeli G, Beccati F.A 4-month-old Thoroughbred filly was referred for evaluation of severe left forelimb lameness of 24 hours duration. Radiographic projections of the shoulder revealed mild irregularity and sclerosis of the proximal humeral apophysis. Ultrasonographic examination showed a moderate increase in the amount of anechogenic synovial fluid within the intertubercular bursa and scapulohumeral joint, and irregularity of the ossifying bone surface of the intermediate tubercle of the humerus. Computed tomographic (CT) examination revealed a circular hypoattenuating area at the level of the proximal apophysi...
Medina-Torres CE, Underwood C, Pollitt CC, Castro-Olivera EM, Hodson MP, Richardson DW, van Eps AW.Failure of lamellar energy metabolism, with or without ischaemia, may be important in the pathophysiology of sepsis-associated laminitis. Objective: To examine lamellar perfusion and energy balance during laminitis development in the oligofructose model using tissue microdialysis. Methods: In vivo experiment. Methods: Six Standardbred horses underwent laminitis induction using the oligofructose model (OFT group) and 6 horses were untreated controls (CON group). Microdialysis probes were placed in the lamellar tissue of one forelimb (all horses) as well as the skin dermis of the tail in OFT hor...
Tadros EM, Frank N, Newkirk KM, Donnell RL, Horohov DW.The role of endotoxemia in the development of laminitis remains unclear. Although systemic inflammation is a risk factor for laminitis in hospitalized horses, experimental endotoxin administration fails to induce the disease. While not sufficient to cause laminitis by itself, endotoxemia might predispose laminar tissue to damage from other mediators during systemic inflammation. In "two-hit" models of organ damage, sequential exposure to inflammatory stimuli primes the immune system and causes exaggerated inflammatory responses during sepsis. Acute laminitis shares many characteristics with se...
